Childcare Consent

Parent/Legal Guardian's Name

This address will receive a confirmation email

Phone

Emergency Contact's Name (if different or in addition to legal guardian)

Emergency Contact's Phone

Child(ren)'s name(s) and ages

Relevant medical information (including, but not limited to, allergies and health conditions, such as asthma)

Covid-19 protocols

I would like my child(ren) to wear a mask at all times I would like my child(ren) to wear a mask when indoors I have no preference on whether or not my child(ren) wear a mask

Bathroom protocols: Ma’alot wants to ensure that every child is safe at all times. Please select the option that represents how you wish us to handle bathroom breaks for your child(ren)

I or another adult I designate will escort my child(ren) to the bathroom. If/when my child(ren) need to use the bathroom please bring my child inside the main room and get my attention. I am comfortable with a Ma’alot volunteer/staff member taking my child to the bathroom.

Anything else you want us to know?

As a parent or legal guardian, I confirm that I have been informed that Ma'alot will be providing optional childcare at this event from an experienced babysitter. By typing my full name here, I affirm that I have filled out this form completely and provided all relevant medical information. I understand that, if I have not filled out this form completely, I can be denied childcare upon arrival to this event. I consent to leave my child(ren) in the care of a Ma'alot hired babysitter. Ma'alot's hired caretakers with proper certifications are permitted to perform CPR or first aid on my child(ren) if necessary. I will not take legal action against Ma'alot or individual caretakers in the case of accidental injury.

Description

Ma'alot will be providing optional childcare at this event from an experienced babysitter. Please fill out this consent form if you wish to leave your child in the care of Ma'alot's hired caretakers.

Childcare Consent

Description

Please Fix the Following